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Emergency EOR > Behavioral Health > Flashcards

Behavioral Health Flashcards

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1
Q

> 1 manic or mixed episode which often cycles with occasional depressive episodes (but major depressive episodes are not required for diagnosis)

A

Bipolar I Disorder

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2
Q

Strongest risk factor for bipolar I disorder

A

Family history (1st degree relatives)

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3
Q

Average age of onset for bipolar I disorder

A

20s-30s

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4
Q

Abnormal and persistently elevated, expansive or irritable mood at least 1 week (or less if hospitalization is required) with marked impairment of social/occupational function

A

Mania

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5
Q

Management of bipolar disorder

A
  1. Lithium first line
  2. Valproic acid, carbamazepine
  3. Haloperidol or Benzos if psychosis or agitation develops
  4. Therapy
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6
Q

> 1 hypomanic episode + > 1 major depressive episode. mania or mixed episodes are absent

A

Bipolar II disorder

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7
Q

Symptoms similar to manic symptoms - period of elevated, expansive, or irritable mood at least 4 days that is clearly different from the usual nondepressed mood but does not cause marked impairment, no psychotic features and does not require hospitalization

A

Hypomania

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8
Q

Management of bipolar II disorder

A

Acute mania - lithium, valproate
Depression - lithium, valproate, carbamazepine
Mixed - atypical antipsychotics, valproate

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9
Q

> 1 delusion lasting > 1 month without other psychotic symptoms. Apart from delusion, behavior is not obviously odd or bizarre and there is no significant impairment of function. Not explained by another disorder

A

Delusional Disorder

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10
Q

> 1 psychotic symptom with onset and remission < 1 month

A

Brief psychotic disorder

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11
Q

Meets criteria for schizophrenia but < 6 months duration

A

Schizophreniform disorder

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12
Q

Schizophrenia + mood disturbance (major depressive or manic episode)

A

Schizoaffective disorder

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13
Q

> 6 months duration of illness with 1 month of acute symptoms along with functional decline

A

Schizophrenia

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14
Q

Risk factors for schizophrenia

A

Family history

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15
Q

Management for schizophrenia

A
  1. Hospitalization for acute psychotic episodes
  2. 1st line: risperidone, olanzapine, quetiapine
  3. Clozapine in refractory cases
  4. Haloperidol, Chlorpromazine
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16
Q

Risk factors for depressive disorders

A

Family history
Female (2:1)
Highest incidence 20s-40s

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17
Q

Depressed mood or anhedonia or loss of interest in activities with > 5 associated symptoms almost every day for at least 2 weeks

A

Major depressive disorder

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18
Q

The presence of depressive symptoms at the same time each year (most common in winter)

A

Seasonal Affective Disorder/Seasonal Pattern

19
Q

Management of seasonal affective disorder/seasonal pattern

A

SSRIs
Light therapy
Bupropion

20
Q

Shares many of the typical symptoms of MDD but patients experience mood reactivity (improved mood in response to positive events). Sx include significant weight gain/appetite increase, hypersomnia

A

Atypical depression

21
Q

Treatment of atypical depression

A

MAO inhibitors

22
Q

Characterized by anhedonia (inability to find pleasure in things), lack of mood reactivity, depression, severe weight loss/loss of appetite, excessive guilt, psychomotor agitation or retardation and sleep disturbance

A

Melancholia

23
Q

Motor immobility, stupor and extreme withdrawal

A

Catatonic Depression

24
Q

Screening for depression

A

PHQ-2 for initial screen

If positive, use PHQ-9

25
Q

Management of major depressive disorder

A
  1. Principal therapy: psychotherapy - CBT, support groups
  2. SSRIs, SNRIs
  3. Bupropion and Mirtazapine
  4. ECT
26
Q

Excessive anxiety or worry for a majority of days > 6 month period about various aspects of life

A

Generalized Anxiety Disorder

27
Q

Management of generalized anxiety disorder

A
  1. SSRIs, SNRIs
  2. Buspirone
  3. Benzos, beta blockers, TCAs
  4. Psychotherapy: CBT
28
Q

Persistent (> 6 mo) intense fear of social or performance situations in which the person is exposed to the scrutiny of others for fear of embarrassment (ex. public speaking, meeting new people, eating/drinking in front of people)

A

Social anxiety disorder

29
Q

Management of social anxiety disorder

A
  1. SSRIs, SNRIs
  2. Beta blockers
  3. Benzos
  4. Psychotherapy
30
Q

Recurrent, unexpected panic attacks (at least 2 attacks) may or may not be related to a trigger. Usually sudden in onset, peaks within 10 minutes and usually lasts < 60 minutes

A

Panic disorder

31
Q

Anxiety about being in places or situations from which escape may be difficult (open spaces, enclosed spaces, crowds, public transportation)

A

Agoraphobia

32
Q

Management of panic disorder

A
  1. SSRIs, SNRIs
  2. CBT
    Acute attack - benzo
33
Q

Management of PTSD

A
  1. SSRIs
  2. MAO inhibitors
  3. Trazodone for insomnia
  4. CBT
34
Q

Management of tobacco dependence

A
  1. CBT
  2. Nicotine gum, nasal sprays, transdermal patches, inhaler, lozenges
  3. Bupropion
  4. Varenicline (Chantix)
35
Q

Physical exam findings for opioid abuse

A
  1. Pupillary restriction
  2. Respiratory depression
  3. Biot’s breathing
  4. Bradycardia
  5. Hypotension
36
Q

Groups of quick, shallow inspirations followed by regular or irregular periods of apnea

A

Biot’s Breathing

Seen with opioid abuse

37
Q

Symptoms of opioid withdrawal

A

Goosebumps (piloerections)
Pupil dilation
Flu-like symptoms
N/V

38
Q

Management of acute intoxication of opioid

A

Naloxone (Narcan)

39
Q

Management of opioid withdrawal

A

Clonidine
Methadone tapering
Buphrenorphine + Naloxone
Benzos may be helpful

40
Q

Signs/symptoms of alcohol withdrawal

A
  1. Increased CNS activity - anxiety, tremors, diaphoresis, palpitations
  2. Withdrawal seizures
  3. Hallucinosis
  4. Delirium tremens
41
Q

Management of alcohol withdrawal

A
  1. Requires hospitalization - can be fatal
  2. IV benzos
  3. IV thiamine and magnesium (prior to glucose admin)
42
Q

Medication that can be used as a deterrent to alcohol abuse

A

Disulfiram

43
Q

Strongest single predictive factor of suicide

A

Previous attempt or threat

Emergency EOR (12 decks)

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